A nurse is providing care to multiple clients on the postpartum unit.

Which of the following clients is at the greatest risk for developing a puerperal infection?

A client who has a cesarean incision that is well-approximated with no drainage.

A client who does not wash her hands between perineal care and breastfeeding.

A client who has an episiotomy that is erythematous and has extended into a third-degree laceration.

A client who is not breastfeeding and is using measures to suppress lactation.

Answer and Explanation

The Correct Answer is C

Choice A rationale
A client who has a cesarean incision that is well-approximated with no drainage is not at the greatest risk for developing a puerperal infection. While any surgical incision can potentially become infected, if the incision is healing well with no signs of infection, the risk is relatively low.
Choice B rationale
A client who does not wash her hands between perineal care and breastfeeding is increasing her risk of infection, but this is not the greatest risk factor for developing a puerperal infection. Good hand hygiene is important to prevent the spread of germs, but other factors pose a greater risk for puerperal infection.
Choice C rationale
A client who has an episiotomy that is erythematous and has extended into a third-degree laceration is at the greatest risk for developing a puerperal infection. An episiotomy is a surgical cut made at the opening of the vagina during childbirth to aid a difficult delivery and prevent rupture of tissues. If the episiotomy extends and becomes a third-degree laceration, it involves the vaginal tissue, perineal skin, and the muscle of the perineum, and can extend into the anal sphincter, the muscle that surrounds the anus. This type of wound provides a medium for bacterial growth, increasing the risk of infection.
Choice D rationale
A client who is not breastfeeding and is using measures to suppress lactation is not at the greatest risk for developing a puerperal infection. While breastfeeding can help reduce the risk of certain types of infections, not breastfeeding does not significantly increase the risk of puerperal infection.

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Correct Answer is A

Explanation

Choice A rationale
Practicing Kegel exercises is a common recommendation for postpartum women experiencing urinary incontinence. Kegel exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine, and rectum. Strengthening these muscles can help control urinary incontinence.
Choice B rationale
Abdominal crunches are not typically recommended for postpartum women, especially those who have had a cesarean birth. These exercises can strain the abdominal muscles and may interfere with the healing process.
Choice C rationale
Similar to abdominal crunches, sit-ups are not typically recommended for postpartum women, especially those who have had a cesarean birth. These exercises can strain the abdominal muscles and may interfere with the healing process.
Choice D rationale
While pelvic tilt exercises can be beneficial for postpartum women, they are not specifically targeted at improving urinary incontinence.

A. The medication should be administered in one large dose every day. B. Our child’s blood count will need to be monitored routinely for several weeks. C. The medication will be more effective if it is administered with meals. D. Restricting fiber from our child’s diet will help absorption of the iron.

Correct Answer is B

Explanation

Choice A rationale
Iron supplements should not be administered in one large dose every day. High doses can cause side effects such as nausea, vomiting, diarrhea, constipation, and dark stools.
Choice B rationale
Monitoring blood count routinely for several weeks is necessary when a child is taking iron supplements for iron deficiency anemia. This helps to ensure that the supplement is effective and that iron levels are being restored to a healthy range.
Choice C rationale
Iron supplements are not necessarily more effective if administered with meals. In fact, some studies suggest that taking iron supplements with food might decrease the amount of iron absorbed.
Choice D rationale
Restricting fiber from a child’s diet will not necessarily help with the absorption of iron. In fact, a balanced diet, including fiber, is important for overall health.

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A nurse is providing care to multiple clients on the postpartum unit. Which of the following clients is at the greatest risk for developing a puerperal infection?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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A nurse is providing care to multiple clients on the postpartum unit.

Which of the following clients is at the greatest risk for developing a puerperal infection?